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Organization

PERINE ENTERPRISES INC.

Active
Other names
DOUG'S PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JASON PERINE PHARM D (PIC)
(785) 584-6722
Entity
Organization

Contact information

Practice address
430 N MAIN ST, ROSSSVILLE, KS 66533
(785) 584-6722
(785) 584-6513
Mailing address
PO BOX 707, ROSSVILLE, KS 66533-0707
(785) 584-6722
(785) 584-6513

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2-05477
KS
333600000X
Pharmacy
Primary
2-05477
KS
3336C0003X
Community/Retail Pharmacy
2-05477
KS
3336L0003X
Long Term Care Pharmacy
2-05477
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100437350A
KS
01
1708075
NCPDP
KS
01
205477
PHARMACY PERMIT
KS
Enumeration date
06/16/2005
Last updated
03/07/2023
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